The Complete Guide to Non Invasive Fat Loss and Body Shaping
Part I : 5 tips to evaluate your weight loss clinic.
Losing inches has never been more easy, or more confusing! A number of new technologies have now come up, and some of them are truly brilliant at busting fat. Here we will evaluate the merits and demerits of some of the best performing fat reduction technologies.
I have kept the discussion below, to include only the truly effective fat loss treatments, to minimise confusion and to keep the concepts clear. If you do not find any particular tech below, it is because I do not find it to be effective, or because it is still not around in India for long enough, to assess its efficacy in our population.
The technologies
There are many ways to target and destroy the fat cells. While the older techniques focused primarily on fat cell shrinking, the current techniques all focus on fat cell destruction.
The most powerful techs currently available for killing off fat cells are ultrasound energy, extreme cooling to destroy fat, also called cryolipolysis, radiofrequency energy and lasers. Simple heating as is offered in many spas, doesnt quite work, nor do massages. Lymphatic drainage works to help clear the fat faster, AFTER, it has been busted by one of the effective processes above, but not by itself as a stand alone procedure.
We will discuss the individual technologies, after we have had a look at the basics.
The basics
It is important to be very clear of your goals. What are you actually trying to achieve? Is it a question of ‘I am fat — I need to lose weight’ or is inch loss your clear goal? Or are you already in shape, except for a few troublesome areas of stubborn fat? These are the questions that you should ask yourself before you go in for a consultation — or at least, these are the questions your doctor and you need to discuss, right at your first consultation.
Important tip 1: If your doctor skips this question, skip the doctor.
Why is this so important? Because the invasive (aka liposuction) and non invasive fat removal treatments work only on the subcutaneous fat — the pinchable fat below your skin, and ABOVE your muscle layer.
You have got to understand this well : the overall obese individual, has not just the pinchable, subcutaneous kind of fat to melt, but a different type of fat — called the visceral fat — that sits around your internal organs and BELOW the muscle layer.
(This distinction of fat location above and below the muscle layers is an oversimplification — but I offer it here, as a way to understand the concept better).
The illustration above(Image courtesy — Syneron Candela) below will help to understand things a little better. The subcutaneous fat is lighter purple, as compared to the deep purple visceral fat. Any fat loss treatment cannot and should not touch the visceral fat. One of the dreaded complications of liposuction, when performed by poorly trained / unqualified individuals, is entering the area deeper to the muscle — which can be potentially fatal. So, is there any surgical on non surgical procedure at all that can remove visceral fat? Unfortunately no, and many people do ask that question!
So if a person is obese, and has a much higher proportion of visceral fat as compared to subcutaneous fat, then it would not make sense to rely only on the fat loss techniques, to provide overall body shaping and weight loss. This person definitely needs a restructuring of his or her diet. He or she also needs a detailed evaluation for general overall health, and for any specific problems that could be affecting the metabolic axis, and a plan to manage the findings of the evaluation. Often, an endocrinologist’s opinion can be of great help in managing metabolic issues — which then makes the busting of the visceral fat much easier.
Tip 2: If this discussion about your general health doesn’t happen at your weight loss clinic, you can expect your body shaping to not happen!
Even as we discuss the fat above and below the muscle, the muscle itself it a very important factor in body contouring. This is more significant in women as compared to men, but I do see men with a weakness of the central abdomen, from time to time. Before we discuss this further, the muscle factor is important only in the abdomen. Other areas do not depend much on the underlying muscle tone, but working out the muscles in any area definitely adds to the definition of the contour.
The important term to understand here — is something called diastasis recti — or separation of the 6 pack muscles, to put it simply. The recti muscles, the transverse and oblique abdominal muscles — must all maintain anatomic integrity for a flat, strong abdomen.
This integrity gets compromised during the process of pregnancy and delivery — more with Caesarean sections than with normal deliveries. Unless this is targeted and treated specifically, it does not allow the abdomen to ever become flat, and what’s more this could put the person at risk for a hernia later.
Chronic back pain also could be a problem because of the lack of postural support from the frontal abdominal muscles. This specifically needs an evaluation, and sorting out, and not all physical trainers are equipped to deal with this. In fact, someone working on you without an awareness of this issue, can actually worsen the problem by choosing the wrong kind of exercise, say indiscrimate crunching to get rid of the tummy!
You need to consult a post partum fitness specialist particularly for this. I strongly recommend someone like Santy Chandran, who is pioneering this concept in her Lytr fitness.
Important Tip 3: Before signing up for any fat loss procedure, invasive or non invasive — your doctor needs to evaluate you for abdominal wall laxity (particularly in women, and obese men), if the tummy is what you are trying to reduce! If the doctor fails to do this, your treatment may fail to reach your goal of a flat abdomen!
So now that we have some plan made for the visceral fat, and the muscle layer, we can move to the treatment approach for subcutaneous fat loss.
First stop, is the likelihood for sagging. Let us look at the most commonly treated areas for women, and for men. The top treatment areas for the men are the love handles and the male breast. While for women, the top areas are the arms, and the outer thighs, and the mommy make over — for moms, which targets the abdomen and the hips.
As compared to simple fat busting, the mommy make over also needs to handle skin laxity or sagging and stretch marks, usually. If there is a big component of sagging, then liposuction is a strict no- no, as it will only worsen the sagging.
Unless you are also opting for some corrective excision of sagging skin, plain liposuction alone would aggravate the sagging by removing what fat support there was, earlier.
For those with sagging, non invasive procedures are a real boon. By stretching out the fat dissolution process organically, over a period of 3–4 months, the sagging can be dealt with much more effectively, than by an single day, rapid removal of the fat. Again this period of 3–4 months can be an advantage, as it provides a window for scheduling tightening and lifting treatments. At RENDER, we intersperse the fat reduction with lifting and tightening to achieve a more complete contouring. As stretch marks also improve with the lift and tighten treatments, it is a win- win outcome.
If the component of sagging is minimal, then liposuction may be adequate. Here again, with the whole world moving from surgical to non surgical, non invasive fat loss treatments still score over invasive methods for the sheer lack of surgical complications, and downtime. All that said, some plastic surgeons do an excellent job, and you could / should always evaluate all your options before settling down for the one that suits you the most.
Important Tip 4: Your clinic should be able to offer a plan for inch loss, and for sagging. Otherwise, you shouldn’t be offering yourselves up for treatment, there.
Next up, is the area itself. We discussed the top areas for both genders, but even in a given individual, different areas perform differently — the reason being the fat tissue architecture, effect of gravity, ratio of simple sagging to actual fat, underlying muscle tone and so on. It is very important to clearly understand this, as not all areas are managed the same.
For the arms, tightening is as important as fat reduction. For the thighs, big results are possible even with lesser number of treatments — if the area is chosen strategically.
We discussed the abdomen in detail, above. Areas like the love handles, are absolute value for money, since the results are noticeable right away.
So, it is crucial that a trained medical person — a doctor, manages this part, of deciding the treatment area and the treatment strategy. The technology also contributes to this step — marking the treatment area is different for Ultrashape Power as compared to Coolsculpting.
Planning the treatment over the bony areas, should be very different for Ultrashape Power and Coolsculpting — this is because over bony areas, pain — during, and especially after, the treatment can be much more for Coolsculpting. With Ultrashape Power, it is very important to mark out exactly where there should be an overlap, because fat blasting at Ultrashape happens at depth of 0.5 to 2.5 cm, with a peak performance at 1.5 cm. If the fat loss can lead to sagging, or if I am treating sagging after bariatric surgery, then I use a lot of radiofrequency energy in my ultrasound based protocol.
So the point here, is that the treatment protocols have be to customised to
a) Gender — we discussed that above
b)Age — the time to recovery is the same, but age related sagging has to be considered.
c) Goal — Inch loss or overall weight loss
d)Obesity — there should always, be a plan for managing the visceral fat. This allows you to truly enjoy the results of your non invasive shaping programs.
e) Recent surgical procedures including liposuction, bariatric surgery, risk assessment for any health issues . Coolsculpting particularly needs one to rule out conditions that can be worsened with cold, example being cryoglobulinemia. It is also important to look for a history of cardiac surgery or any implants which may or may not interfere with the machine’s circuitry)
f)Pregnancy planning — I generally do not prefer to perform a body shaping treatment, if there is an upcoming pregnancy within 3 to 6 months. This is because, by the time the results start getting noticeable, pregnancy will start its fat storage process, to cushion the body for the extra metabolic requirements. No procedure is to be performed when someone is actually pregnant.
g)Nursing and post partum period — I am okay to start the preliminary process as early as 6 weeks after a normal delivery, and 3 months after a C-section.
h)Skin integrity — Infections and injuries over the area to be treated, should be treated first, before planning any of the procedures. Some equipment are known to cause burns, so it is important to eliminate any potential trouble.
Well, the list is long. Which is why, we have a checklist.
So, the 5th and the most important tip — If there is no checklist, check the clinic off your list!
Does your doctor spend enough time to make sure that you are healthy enough to undergo the procedure? Is your doctor a recognised authority in this field? Is there sufficient medical expertise in your clinic, that makes sure that the treatments will most likely work for you? We all are aware that there is no 100% guarantee for any procedure like body shaping, which depends on multiple factors — but, is there a customised strategy to make sure that most of these factors are covered? So this should be the most important factor why which you choose your clinic.
Now that we have covered the factors that can make a big difference to the treatment outcome, we will follow this up with a detailed coverage of the different technologies.